Individual
DR. THOMAS RICHARD MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1020 NE 2ND AVE, SUITE 300, PORTLAND, OR 97232-2064
(503) 230-7978
(503) 230-0232
Mailing address
1020 NE 2ND AVE, SUITE 300, PORTLAND, OR 97232-2064
(503) 230-7978
(503) 230-0232
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D6647
OR
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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